Dose-ranging antiemetic trial of high-dose oral metoclopramide Journal Article


Authors: Tyson, L. B.; Gralla, R. J.; Kris, M. G.; Young, C. W.; Clark, R. A.
Article Title: Dose-ranging antiemetic trial of high-dose oral metoclopramide
Abstract: The present trial with high oral doses of metoclopramide was undertaken to (a) determine a well-tolerated dosage of oral metoclopramide; (b) measure the blood levels achieved with these oral doses; (c) determine the side effects of high doses; and (d) observe for antiemetic efficacy. Thirty-six patients receiving emesis-producing chemotherapy consisting primarily of high intravenous (i.v.) doses of cyclophosphamide plus adriamycin or cisplatin received 48 courses of oral metoclopramide. The metoclopramide dosage was escalated in six steps from 0.5 to 3.0 mg/kg and was given 1/2 h before chemotherapy, then 1 1/2 , 3 1/2 , 7 1/2 , 11 1/2 , and 15 1/2 h after chemotherapy. Diphenhydramine (50 mg orally) was given with the first, third, and fifth dosages. Toxicity was generally mild, not dose related, and similar to that observed with the i.v. drug with the exception of an increased incidence of acute dystonic reactions. Antiemetic effects were observed at each dose level. In patients receiving oral metoclopramide doses of 2 or 3 mg/kg, all achieved serum levels > 1,000 ng/ml. High-dosage oral metoclopramide was well tolerated and demonstrated antiemetic effects at the dose levels explored. We recommend 2-3 mg/kg oral metoclopramide doses with 50 mg diphenhydramine for use in future trials.
Keywords: cancer chemotherapy; clinical article; cisplatin; doxorubicin; letter; nausea; vomiting; metoclopramide; intravenous drug administration; oral drug administration; diphenhydramine; antiemetic activity; male; female; dystonic reaction
Journal Title: American Journal of Clinical Oncology
Volume: 12
Issue: 3
ISSN: 0277-3732
Publisher: Lippincott Williams & Wilkins  
Date Published: 1989-06-01
Start Page: 239
End Page: 243
Language: English
DOI: 10.1097/00000421-198906000-00012
PUBMED: 2658539
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 14 April 2020 -- Source: Scopus
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MSK Authors
  1. Mark Kris
    870 Kris
  2. Leslie Tyson
    70 Tyson
  3. Charles W Young
    82 Young
  4. Richard J. Gralla
    69 Gralla
  5. Rebecca Clark
    21 Clark